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Effectiveness of integrase strand transfer inhibitor-based regimens in HIV-infected treatment-native individuals

2021-09-01Artigo científico Acesso aberto
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dc.contributor.authorRossetti, Barbara
dc.contributor.authorFabbiani, Massimiliano
dc.contributor.authorDi Carlo, Domenico
dc.contributor.authorIncardona, F.
dc.contributor.authorAbecasis, A.
dc.contributor.authorGomes, Perpetua
dc.contributor.authorGeretti, A. M.
dc.contributor.authorSeguin-Devaux, C.
dc.contributor.authorGarcia, Federico
dc.contributor.authorKaiser, Rolf
dc.contributor.authorModica, Sara
dc.contributor.authorShallvari, Adrian
dc.contributor.authorSönnerborg, A.
dc.contributor.authorZazzi, M.
dc.contributor.authorBobkova, M.
dc.contributor.authorSeguin-Devaux, C.
dc.contributor.authorParedes, R.
dc.contributor.authorSayan, M.
dc.contributor.authorVandamme, A. M.
dc.contributor.institutionTB, HIV and opportunistic diseases and pathogens (THOP)
dc.contributor.institutionGlobal Health and Tropical Medicine (GHTM)
dc.contributor.institutionInstituto de Higiene e Medicina Tropical (IHMT)
dc.contributor.pblBritish Society for Antimicrobial Chemotherapy | Oxford University Press
dc.date.accessioned2021-09-24T02:25:09Z
dc.date.available2021-09-24T02:25:09Z
dc.date.issued2021-09-01
dc.descriptionPublisher Copyright: © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
dc.description.abstractBackground: INSTIs have become a pillar of first-line ART. Real-world data are needed to assess their effectiveness in routine care. Objectives: We analysed ART-naive patients who started INSTI-based regimens in 2012-19 whose data were collected by INTEGRATE, a European collaborative study including seven national cohorts. Methods: Kaplan-Meier analyses assessed time to virological failure (VF), defined as one viral load (VL) ≥1000 copies/mL, two consecutive VLs ≥50 copies/mL, or one VL ≥50 copies/mL followed by treatment change after ≥24 weeks of follow-up, and time to INSTIs discontinuation (INSTI-DC) for any reason. Factors associated with VF and INSTI-DC were explored by logistic regression analysis. Results: Of 2976 regimens started, 1901 (63.9%) contained dolutegravir, 631 (21.2%) elvitegravir and 444 (14.9%) raltegravir. The 1 year estimated probabilities of VF and INSTI-DC were 5.6% (95% CI 4.5-6.7) and 16.2% (95% CI 14.9-17.6), respectively, and were higher for raltegravir versus both elvitegravir and dolutegravir. A baseline VL ≥100 000 copies/mL [adjusted HR (aHR) 2.17, 95% CI 1.55-3.04, P < 0.001] increased the risk of VF, while a pre-treatment CD4 count ≥200 cells/mm3 reduced the risk (aHR 0.52, 95% CI 0.37-0.74, P < 0.001). Predictors of INSTI-DC included use of raltegravir versus dolutegravir (aHR 3.03, 95% CI 2.34-3.92, P < 0.001), use of >3 drugs versus 3 drugs (aHR 2.73, 95% CI 1.55-4.79, P < 0.001) and starting ART following availability of dolutegravir (aHR 0.64, 95% CI 0.48-0.83, P = 0.001). Major INSTI mutations indicative of transmitted drug resistance occurred in 2/1114 (0.2%) individuals. Conclusions: This large multi-cohort study indicates high effectiveness of elvitegravir- or dolutegravir-based first-line ART in routine practice across Europe.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent6
dc.format.extent338044
dc.identifier.doi10.1093/jac/dkab200
dc.identifier.issn0305-7453
dc.identifier.otherPURE: 33793803
dc.identifier.otherPURE UUID: 3024eecf-813b-42f6-9c2f-1fb43428c297
dc.identifier.otherScopus: 85114380094
dc.identifier.otherPubMed: 34212176
dc.identifier.urihttp://hdl.handle.net/10362/125098
dc.identifier.urlhttps://www.scopus.com/pages/publications/85114380094
dc.language.isoeng
dc.peerreviewedyes
dc.subjectPharmacology
dc.subjectMicrobiology (medical)
dc.subjectInfectious Diseases
dc.subjectPharmacology (medical)
dc.subjectSDG 3 - Good Health and Well-being
dc.subjectSDG 9 - Industry, Innovation, and Infrastructure
dc.subjectSDG 12 - Responsible Consumption and Production
dc.titleEffectiveness of integrase strand transfer inhibitor-based regimens in HIV-infected treatment-native individualsen
dc.title.subtitleResults from a European multi-cohort studyen
dc.typejournal article
degois.publication.firstPage2394
degois.publication.issue9
degois.publication.lastPage2399
degois.publication.titleJournal of Antimicrobial Chemotherapy
degois.publication.volume76
dspace.entity.typePublication
rcaap.rightsopenAccess

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